Neuropediatrics 2008; 39(1): 46-50
DOI: 10.1055/s-2008-1076740
Short Communication

© Georg Thieme Verlag KG Stuttgart · New York

L-Asparaginase-induced Posterior Reversible Encephalopathy Syndrome during Acute Lymphoblastic Leukemia Treatment in Children

R. Hourani 1 , M. Abboud 2 , M. Hourani 1 , H. Khalifeh 3 , S. Muwakkit 2
  • 1Department of Diagnostic Radiology, American University of Beirut Medical Center, Beirut, Lebanon
  • 2Children's Cancer Center, American University of Beirut Medical Center, Beirut, Lebanon
  • 3Rafik Hariri University Hospital, Beirut, Lebanon
Further Information

Publication History

received 09.11.2007

accepted 18.03.2008

Publication Date:
26 May 2008 (online)


l-Asparaginase is a critical component in the treatment of acute lymphoblastic leukemia in children. It is known to cause coagulation abnormalities, thrombosis and hemorrhage in the central nervous system in addition to vasculitis and hypersensitivity reactions. The purpose of this article is to present the first case-series of posterior reversible encephalopathy syndrome (PRES) associated with l-asparaginase treatment. We report 3 cases of children with acute lymphoblastic leukemia who developed seizures and altered sensorium after l-asparaginase therapy. MRI showed increased T2 signal intensity predominant in the posterior regions of the brain suggestive of PRES. Two of our patients developed septic shock and deteriorated whereas one patient improved and recovered completely.


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R. HouraniMD 

Department of Diagnostic Radiology

The American University of Beirut Medical Center

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